Over 30 years since Alternative Social Agencies (Perlmutter, 1988) was published, scholars from a range of disciplines have studied alternative approaches to human service administration, management, and leadership. In this paper, we pull the historical threads of alternative voices into the web of contemporary practice and memorialize Perlmutter’s legacy to social work education and practice. We begin with an historical perspective, framing the concept of an alternative agency and establishing the narrative in which Perlmutter’s book was incubated. We then review the literature that has emerged on alternative agencies and build on her quest to conceptualize what it means to be an “alternative agency,” using the subtype of feminist organizations as an exemplar. Finally, based on a review of this diverse literature, and grounded in the factors for success originally identified by Perlmutter, we identify lessons learned about strategies used in contemporary alternative agencies and their implications for human service leadership.
{"title":"Alternative Agencies and Feminist Organizations:Building on the Legacy of Felice DavidsonPerlmutter","authors":"","doi":"10.37808/jhhsa.43.3.2","DOIUrl":"https://doi.org/10.37808/jhhsa.43.3.2","url":null,"abstract":"Over 30 years since Alternative Social Agencies (Perlmutter, 1988) was published, scholars from a range of disciplines have studied alternative approaches to human service administration, management, and leadership. In this paper, we pull the historical threads of alternative voices into the web of contemporary practice and memorialize Perlmutter’s legacy to social work education and practice. We begin with an historical perspective, framing the concept of an alternative agency and establishing the narrative in which Perlmutter’s book was incubated. We then review the literature that has emerged on alternative agencies and build on her quest to conceptualize what it means to be an “alternative agency,” using the subtype of feminist organizations as an exemplar. Finally, based on a review of this diverse literature, and grounded in the factors for success originally identified by Perlmutter, we identify lessons learned about strategies used in contemporary alternative agencies and their implications for human service leadership.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44507475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictors of Success and Failure in Cross-sectoral Partnerships in Nonprofit Human Services: Reflections and Challenges","authors":"","doi":"10.37808/jhhsa.43.3.3","DOIUrl":"https://doi.org/10.37808/jhhsa.43.3.3","url":null,"abstract":"","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":"5 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41264251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Communities across the U.S. have been challenged with effectively and efficiently addressing the incidence of homeless. The needs of those experiencing homelessness are varied and complex, and chief among these needs is access to affordable primary health care services. Research indicates that individuals experiencing homelessness are at higher risk of preventable diseases and also are less likely to access health care systems than most other populations. Because federal law delegates the provision of health and human services to local entities such as nonprofits, local governments, and private hospitals, communities create collaborative networks known as Continuum of Care (CoCs) to pool local resources and coordinate community-based health and human services. We conduct an original research by launching a national survey to community service networks, and from data collected, we offer knowledge about the type and variety of health care services made available across communities and the multidimensional factors that are associated with the extent to which communities are responding to the primary health care needs of a vulnerable population. We found that homeless medical service needs and community service resources are associated with the degree to which a CoC provides health care services.
{"title":"A Study of Cross-Sector Health Care Services for the Homeless: Community Health Service Capacity Measured and Tested","authors":"","doi":"10.37808/jhhsa/43.2.6","DOIUrl":"https://doi.org/10.37808/jhhsa/43.2.6","url":null,"abstract":"Communities across the U.S. have been challenged with effectively and efficiently addressing the incidence of homeless. The needs of those experiencing homelessness are varied and complex, and chief among these needs is access to affordable primary health care services. Research indicates that individuals experiencing homelessness are at higher risk of preventable diseases and also are less likely to access health care systems than most other populations. Because federal law delegates the provision of health and human services to local entities such as nonprofits, local governments, and private hospitals, communities create collaborative networks known as Continuum of Care (CoCs) to pool local resources and coordinate community-based health and human services. We conduct an original research by launching a national survey to community service networks, and from data collected, we offer knowledge about the type and variety of health care services made available across communities and the multidimensional factors that are associated with the extent to which communities are responding to the primary health care needs of a vulnerable population. We found that homeless medical service needs and community service resources are associated with the degree to which a CoC provides health care services.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43372961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Homelessness is among the most urgent crises facing the United States. In addition to tents or sleeping bags on urban sidewalks, many people experiencing homelessness exist outside of public view, along rivers and other waterways, and elsewhere “out in nature.” This paper explores reasons individuals live near waterways, specific health and human service needs of this population, and why these needs remain largely unmet. We conducted in-depth, semi-structured interviews with 84 individuals experiencing homelessness, 56 of whom were currently residing or had previously resided near the San Diego River or in nearby canyons, as well as seven key informant interviews with homelessness services and environmental conservation organizations. Our findings reveal that people live near urban waterways for several reasons, including the competing influences of systems designed to ameliorate the impacts of homelessness, such as criminal justice systems, public health systems, and the emergency shelter system.
{"title":"Unmet Needs of Individuals Experiencing Homelessness Near San Diego Waterways: The Roles of Displacement and Overburdened Service Systems","authors":"S. Flanigan, M. Welsh","doi":"10.37808/jhhsa/43.2.3","DOIUrl":"https://doi.org/10.37808/jhhsa/43.2.3","url":null,"abstract":"Homelessness is among the most urgent crises facing the United States. In addition to tents or sleeping bags on urban sidewalks, many people experiencing homelessness exist outside of public view, along rivers and other waterways, and elsewhere “out in nature.” This paper explores reasons individuals live near waterways, specific health and human service needs of this population, and why these needs remain largely unmet. We conducted in-depth, semi-structured interviews with 84 individuals experiencing homelessness, 56 of whom were currently residing or had previously resided near the San Diego River or in nearby canyons, as well as seven key informant interviews with homelessness services and environmental conservation organizations. Our findings reveal that people live near urban waterways for several reasons, including the competing influences of systems designed to ameliorate the impacts of homelessness, such as criminal justice systems, public health systems, and the emergency shelter system.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42477578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Each year, agencies issue thousands of pages of regulations through the notice and comment process. Given the extensive involvement of the federal government, the health and human services field is particularly affected by this kind of policymaking. Over the past decade, this process has drawn significant scholarly attention. However, policy creation via its close cousin—the agency guidance document development process—is largely unexplored within the fields of public administration and policy. Yet, over time, the utilization and importance of agency guidance has grown enormously. Indeed, in some areas, such as food and drug regulation, agency guidances are now the policy tool of choice for government regulators. This article provides an overview of agency guidance and its important role in the policymaking process. Additionally, it details an October 2019 U.S. presidential executive order on the subject, while also contextualizing the existing literature. The article then reviews select survey results drawn from a study of 41 U.S. Food and Drug Administration (FDA) regulations—20 of which were promulgated using the notice and comment process and 21 via the guidance process—to further illustrate the topic. The results imply a clear need for additional quantitative scholarship to better understand the political and policy underpinnings attached to regulating via agency guidance documents, particularly as they related to health and human services.
{"title":"Policies that Bind? The Use of Guidance Documents by Federal Agencies","authors":"","doi":"10.37808//jhhsa.43.2.1","DOIUrl":"https://doi.org/10.37808//jhhsa.43.2.1","url":null,"abstract":"Each year, agencies issue thousands of pages of regulations through the notice and comment process. Given the extensive involvement of the federal government, the health and human services field is particularly affected by this kind of policymaking. Over the past decade, this process has drawn significant scholarly attention. However, policy creation via its close cousin—the agency guidance document development process—is largely unexplored within the fields of public administration and policy. Yet, over time, the utilization and importance of agency guidance has grown enormously. Indeed, in some areas, such as food and drug regulation, agency guidances are now the policy tool of choice for government regulators. This article provides an overview of agency guidance and its important role in the policymaking process. Additionally, it details an October 2019 U.S. presidential executive order on the subject, while also contextualizing the existing literature. The article then reviews select survey results drawn from a study of 41 U.S. Food and Drug Administration (FDA) regulations—20 of which were promulgated using the notice and comment process and 21 via the guidance process—to further illustrate the topic. The results imply a clear need for additional quantitative scholarship to better understand the political and policy underpinnings attached to regulating via agency guidance documents, particularly as they related to health and human services.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47993208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this article is to present the findings of a secondary analysis of quantitative data collected from a public housing community composed of older and disabled adults (n=100) ages 18-92 (Study 1 -2011) and relate these findings to a subsequent qualitative study (Study 2 -2015) completed in the same community. Both study samples included community residents who resided in three high rise buildings situated in one square block in a metropolitan setting. Both older and younger residents’ concerns, including perceived health, psychological and social needs were analyzed using Bronfenbrenner’s social ecology framework. Community residents were predominately African-American with 77% over 50 years of age. Most study measures identified little difference between the older and younger groups. Key physical, social and environment challenges identified included: chronic medical conditions, abuse and safety, psychological distress, and social isolation. A subsequent qualitative study was conducted with older women (50+) within the same community (2015). The qualitative study focused on the life course experiences of women (n = 25) who were survivors of interpersonal trauma. All groups in both the quantitative secondary data analysis and the qualitative study reported low functioning in health and mental health. They also reported social isolation and safety concerns. Identifying the health and well-being related needs of individual housing communities and examining experiences and perceptions of residents should become a priority in designing community interventions to reduce health disparities and improve health and quality of life for members of vulnerable populations. Entities and providers focused on this population should carefully examine how environmental influences such as social isolation and safety concerns impact chronic physical and mental health outcomes.
{"title":"Strengthening Health in Mixed-Age Housing Communities","authors":"","doi":"10.37808/jhhsa/43.2.8","DOIUrl":"https://doi.org/10.37808/jhhsa/43.2.8","url":null,"abstract":"The aim of this article is to present the findings of a secondary analysis of quantitative data collected from a public housing community composed of older and disabled adults (n=100) ages 18-92 (Study 1 -2011) and relate these findings to a subsequent qualitative study (Study 2 -2015) completed in the same community. Both study samples included community residents who resided in three high rise buildings situated in one square block in a metropolitan setting. Both older and younger residents’ concerns, including perceived health, psychological and social needs were analyzed using Bronfenbrenner’s social ecology framework. Community residents were predominately African-American with 77% over 50 years of age. Most study measures identified little difference between the older and younger groups. Key physical, social and environment challenges identified included: chronic medical conditions, abuse and safety, psychological distress, and social isolation. A subsequent qualitative study was conducted with older women (50+) within the same community (2015). The qualitative study focused on the life course experiences of women (n = 25) who were survivors of interpersonal trauma. All groups in both the quantitative secondary data analysis and the qualitative study reported low functioning in health and mental health. They also reported social isolation and safety concerns. Identifying the health and well-being related needs of individual housing communities and examining experiences and perceptions of residents should become a priority in designing community interventions to reduce health disparities and improve health and quality of life for members of vulnerable populations. Entities and providers focused on this population should carefully examine how environmental influences such as social isolation and safety concerns impact chronic physical and mental health outcomes.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45135762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many funders of health and human service organizations require collaborative networks that work together to achieve community-wide outcomes. One such model is Collective Impact, an approach that has gained support as a way to promote collaboration and track progress. However, the limitations of Collective Impact imposed on small or community-led organizations may be crippling, given the technical and human capital needed to sustain demands for data collection and reporting. As a result, it is problematic that Collective Impact, which aims to enhance accountability and effectiveness in the decision-making process, is also creating unintended bias and inequity in funding relationships. The purpose of this research is to identify the challenges of using the Collective Impact model within an urban environment plagued by historical and on-going structural inequalities. This is accomplished through a critical case study of a large funder of health and human service organizations in an urban region of the mid-Atlantic. Analysis of primary and secondary data reveal disparate funding to large nonprofit organizations, despite organizational goals for equitable and inclusive funding across the nonprofit sector as part of the Collective Impact model. Consequently, the funding patterns represent a perpetuation of the status quo with problematic implications given the context of the region’s racial structural inequalities and organizational goals. This article concludes with recommendations for more inclusive approaches for funders working with small and community-based health and human service organizations.
{"title":"Strengthening Community-Based Health and Human Services in the Shadow of Structural Inequality: A Critical Case Study of the Collective Impact Model","authors":"","doi":"10.37808/jhhsa/43.2.7","DOIUrl":"https://doi.org/10.37808/jhhsa/43.2.7","url":null,"abstract":"Many funders of health and human service organizations require collaborative networks that work together to achieve community-wide outcomes. One such model is Collective Impact, an approach that has gained support as a way to promote collaboration and track progress. However, the limitations of Collective Impact imposed on small or community-led organizations may be crippling, given the technical and human capital needed to sustain demands for data collection and reporting. As a result, it is problematic that Collective Impact, which aims to enhance accountability and effectiveness in the decision-making process, is also creating unintended bias and inequity in funding relationships. The purpose of this research is to identify the challenges of using the Collective Impact model within an urban environment plagued by historical and on-going structural inequalities. This is accomplished through a critical case study of a large funder of health and human service organizations in an urban region of the mid-Atlantic. Analysis of primary and secondary data reveal disparate funding to large nonprofit organizations, despite organizational goals for equitable and inclusive funding across the nonprofit sector as part of the Collective Impact model. Consequently, the funding patterns represent a perpetuation of the status quo with problematic implications given the context of the region’s racial structural inequalities and organizational goals. This article concludes with recommendations for more inclusive approaches for funders working with small and community-based health and human service organizations.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43819718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strengthening Community-Based Health and Human Services for All","authors":"","doi":"10.37808//jhhsa.43.2.2","DOIUrl":"https://doi.org/10.37808//jhhsa.43.2.2","url":null,"abstract":"","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41789226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As evidence emerges that health outcomes are determined by factors outside of the clinical health care delivery system, the nonprofit sector’s relevance to supporting positive health outcomes grows through the delivery of community-based services. This paper examines whether nonprofit community-based organizations have the capacity to absorb new referrals from clinical partners. The expectation of increasing referral activity raises concerns over limited nonprofit community carrying capacity. Using Social Network Analysis, we analyze the network of partners that make up two such community systems and determine the prominence of the referral function, the resources most frequently contributed to the network, dependence on primary revenue sources directly related to the clinical health care delivery system, and the community- based organizations’ perceptions of their financial stability and ability to rapidly respond to increasing referrals. The results suggest steps by which referrals from the clinical health care delivery system to community-based organizations can benefit both parties and health outcomes.
{"title":"Community Carrying Capacity to Address Health System Referrals: A Networked Approach","authors":"","doi":"10.37808/jhhsa.43.2.5","DOIUrl":"https://doi.org/10.37808/jhhsa.43.2.5","url":null,"abstract":"As evidence emerges that health outcomes are determined by factors outside of the clinical health care delivery system, the nonprofit sector’s relevance to supporting positive health outcomes grows through the delivery of community-based services. This paper examines whether nonprofit community-based organizations have the capacity to absorb new referrals from clinical partners. The expectation of increasing referral activity raises concerns over limited nonprofit community carrying capacity. Using Social Network Analysis, we analyze the network of partners that make up two such community systems and determine the prominence of the referral function, the resources most frequently contributed to the network, dependence on primary revenue sources directly related to the clinical health care delivery system, and the community- based organizations’ perceptions of their financial stability and ability to rapidly respond to increasing referrals. The results suggest steps by which referrals from the clinical health care delivery system to community-based organizations can benefit both parties and health outcomes.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45284688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines the roles of public libraries in promoting health literacy at the community level. This study asks: What roles do public libraries play in increasing the public's health literacy? and What effects do library-sponsored programs have on health care services utilization? Multiple regression analyses were conducted on how library-sponsored programs affected the following dependent variables: 1) hospitalizations, and 2) public/private health insurance coverage. By combining multi- stage and purposive sampling methods, this study selected 63 municipal public libraries in New Jersey to investigate their offerings of healthcare literacy-related community programs. The study’s findings suggest that library programs are negatively related to the rate of hospitalization and they are positively related to the overall healthcare insurance coverage, although each is not statistically significant. Among the moderating factors, the median household income statistically significantly predicts the likelihood of obtaining health insurance coverage.
{"title":"The Effect of Public Library Programs on Health Services Utilization: A Health Literacy Perspective","authors":"","doi":"10.37808/jhhsa.43.2.4","DOIUrl":"https://doi.org/10.37808/jhhsa.43.2.4","url":null,"abstract":"This study examines the roles of public libraries in promoting health literacy at the community level. This study asks: What roles do public libraries play in increasing the public's health literacy? and What effects do library-sponsored programs have on health care services utilization? Multiple regression analyses were conducted on how library-sponsored programs affected the following dependent variables: 1) hospitalizations, and 2) public/private health insurance coverage. By combining multi- stage and purposive sampling methods, this study selected 63 municipal public libraries in New Jersey to investigate their offerings of healthcare literacy-related community programs. The study’s findings suggest that library programs are negatively related to the rate of hospitalization and they are positively related to the overall healthcare insurance coverage, although each is not statistically significant. Among the moderating factors, the median household income statistically significantly predicts the likelihood of obtaining health insurance coverage.","PeriodicalId":15909,"journal":{"name":"Journal of health and human services administration","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48531403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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